The effect of non‐surgical weight loss interventions on urinary incontinence in overweight women: a systematic review and meta‐analysis

Abstract

Although the aetiology of urinary incontinence can be multifactorial, in some cases weight loss could be considered as a part of the therapeutic approach for urinary incontinence in people who are overweight. The objective of this study was to review and meta-analyse the effect of non-surgical weight loss interventions on urinary incontinence in overweight women. Web of Science, PubMed, Pedro, SPORTDiscus and Cochrane were systematically searched for clinical trials that met the a priori set criteria. Data of women who participated in non-surgical weight loss interventions (diet, exercise, medication or a combination) were included in the meta-analysis. After removing duplicates, 62 articles remained for screening on title, abstract and full text. Six articles (totalling 2,352 subjects in the intervention groups) were included for meta-analysis. The mean change in urinary incontinence (reported as frequency or quantity, depending on the study) after a non-surgical weight loss intervention, expressed as standardized effect size and corrected for small sample sizes (Hedges' g), was -0.30 (95%CI = -0.47 to -0.12). This systematic review and meta-analysis shows evidence that a non-surgical weight loss intervention has the potential to improve urinary incontinence and should be considered part of standard practice in the management of urinary incontinence in overweight women.

Prevalence of urinary incontinence and its association with multimorbidity in women aged 50 years or older: A population‐based study

“…29 A recent systematic review showed that a non-surgical weight loss intervention improves urinary incontinence and should be standard practice in the management of urinary incontinence in overweight women. 30 An association between UI and multimorbidity was also present in a North American study investigating 6,000 women. In that study, an OR ¼ 1.39 was found in women with comorbidities, confirming the increased risk of UI among women with other chronic diseases.…”

“…These are important data, since obesity is a risk factor liable to modification, either in the appearance of the disorder or in the successful treatment of obesity, which can be both clinical and surgical . A recent systematic review showed that a non‐surgical weight loss intervention improves urinary incontinence and should be standard practice in the management of urinary incontinence in overweight women …”

Associations between obesity, physical fitness, and urinary incontinence in non-institutionalized postmenopausal women: The elderly EXERNET multi-center study

“…In addition, female UI is also related with other factors such as parity, type of delivery, previous hormone therapy and urogenital surgery, constipation, existence of pelvic floor disorders or other chronic diseases [29,31,[38][39][40]. Non-surgical weight loss interventions (diet, exercise or a combination of both) may improve female UI [41] and recently it has been shown that under extreme obese conditions, bariatric surgery has been proposed to improve urinary continence [42].…”

Report and Research Agenda of the American Geriatrics Society and National Institute on Aging Bedside‐to‐Bench Conference on Urinary Incontinence in Older Adults: A Translational Research Agenda for a Complex Geriatric Syndrome

“…Obesity is also associated with UI, including stress and urgency UI subtypes, in epidemiological studies and clinical trials . There is evidence from several clinical trials that weight loss in persons with diabetes mellitus and obese women decreases the severity of UI symptoms …”